The stress process in palliative cancer care:A qualitative study on informal caregiving and its implication for the delivery of care

Objective: The primary objective of this study was to examine how the comprehensive nature of the Stress Process Model could elucidate on the stressors associated with caring for a palliative cancer patient. Method: A qualitative research strategy involving home-based face-to-face interviews with 12 bereaved family caregivers was used to examine the caregiving experience. Results: The primary stressors associated with caring for the palliative cancer care patients stemmed from care recipient symptoms and personal care needs. The absence of adequate support from the formal health care delivery system was a consistent message from all participants. There was evidence of financial stress primarily associated with the purchase of private home care to supplement formal care. In contrast, the resources that family caregivers relied on to moderate the stressful effects of caregiving included extended family, friends, and neighbors. While the stress of direct caregiving was high, the study revealed that formal care was also a significant source of stress for family caregivers. Conclusion: It was concluded that an appropriately financed, integrated system of care that followed a person-centered philosophy of care would best meet the needs of the patient and his or her family. © The Author(s) 2010.

Stress processes in caring for an end-of-life family member:Application of a theoretical model

Objectives: Family caregivers play a vital role in maintaining the lives of individuals with advanced illness living in the community. However, the responsibility of caregiving for an end-of-life family member can have profound consequences on the psychological, physical and financial well-being of the caregiver. While the literature has identified caregiver stress or strain as a complex process with multiple contributing factors, few comprehensive studies exist. This study examined a wide range of theory-driven variables contributing to family caregiver stress. Method: Data variables from interviews with primary family caregivers were mapped onto the factors within the Stress Process Model theoretical framework. A hierarchical multiple linear regression analysis was used to determine the strongest predictors of caregiver strain as measured by a validated composite index, the Caregiver Strain Index. Results: The study included 132 family caregivers across south-central/western Ontario, Canada. About half of these caregivers experienced high strain, the extent of which was predicted by lower perceived program accessibility, lower functional social support, greater weekly amount of time caregivers committed to the care recipient, younger caregiver age and poorer caregiver self-perceived health. Conclusion: This study examined the influence of a multitude of factors in the Stress Process Model on family caregiver strain, finding stress to be a multidimensional construct. Perceived program accessibility was the strongest predictor of caregiver strain, more so than intensity of care, highlighting the importance of the availability of community resources to support the family caregiving role.

The Influence of Friction Stir Welding Process Idealization on Residual Stress and Distortion Predictions for Future Airframe Assembly Simulations

The ability to accurately predict residual stresses and resultant distortions is a key product from process assembly simulations. Assembly processes necessarily consider large structural components potentially making simulations computationally expensive. The objective herein is to develop greater understanding of the influence of friction stir welding process idealization on the prediction of residual stress and distortion and thus determine the minimum required modeling fidelity for future airframe assembly simulations. The combined computational and experimental results highlight the importance of accurately representing the welding forging force and process speed. In addition, the results emphasize that increased CPU simulation times are associated with representing the tool torque, while there is potentially only local increase in prediction fidelity.

A material model for multiaxial stretching and stress relaxation of polypropylene under process conditions

Polypropylene sheets have been stretched at 160 °C to a state of large biaxial strain of extension ratio 3, and the stresses then allowed to relax at constant strain. The state of strain is reached via a path consisting of two sequential planar extensions, the second perpendicular to the first, under plane stress conditions with zero stress acting normal to the sheet. This strain path is highly relevant to solid phase deformation processes such as stretch blow moulding and thermoforming, and also reveals fundamental aspects of the flow rule required in the constitutive behaviour of the material. The rate of decay of stress is rapid, and such as to be highly significant in the modelling of processes that include stages of constant strain. A constitutive equation is developed that includes Eyring processes to model both the stress relaxation and strain rate dependence of the stress. The axial and transverse stresses observed during loading show that the use of a conventional Levy-Mises flow rule is ineffective, and instead a flow rule is used that takes account of the anisotropic state of the material via a power law function of the principal extension ratios. Finally the constitutive model is demonstrated to give quantitatively useful representation of the stresses both in loading and in stress relaxation.

A decrease in bulk water and mannitol and accumulation of trehalose and trehalose-based oligosaccharides define a two-stage maturation process towards extreme stress resistance in ascospores of Neosartorya fischeri (Aspergillus fischeri)

Integration Of Strength and Process Modelling of Friction-Stir-Welded Fuselage Panels

In order to reduce potential uncertainties and conservatism in welded panel analysis procedures, understanding of the relationships between welding process parameters and static strength is required. The aim of this study is to determine and characterize the key process induced properties of advanced welding assembly methods on stiffened panel local buckling and collapse performance. To this end, an in-depth experimental and computational study of the static strength of a friction stir welded fuselage skin-stiffener panel subjected to compression loading has been undertaken. Four welding process effects, viz. the weld joint width, the width of the weld Heat Affected Zone, the strength of material within the weld Heat Affected Zone and the magnitude of welding induced residual stress, are investigated. A fractional factorial experiment design method (Taguchi) has been applied to identify the relative importance of each welding process effect and investigate effect interactions on both local skin buckling and crippling collapse performance. For the identified dominant welding process effects, parametric studies have been undertaken to identify critical welding process effect magnitudes and boundaries. The studies have shown that local skin buckling is principally influenced by the magnitude of welding induced residual stress and that the strength of material in the Heat Affected Zone and the magnitude of the welding induced residual stress have the greatest influence on crippling collapse behavior.


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Influence of process parameters on fluidised hot-melt granulation and tablet pressing of pharmaceutical powders

This study investigates the influence of process parameters on the fluidised hot melt granulation of lactose and PEG 6000, and the subsequent tablet pressing of the granules. Granulation experiments were performed to assess the effect of granulation time and binder content of the feed on the resulting granule properties such as mass mean granule size, size distribution, granule fracture stress, and granule porosity. These data were correlated using the granule growth regime model. It was found that the dominant granule growth mechanisms in this melt granulation system were nucleation followed by steady growth (PEG 10–20% w/w). However, with binder contents greater than 20% w/w, the granulation mechanism moved to the “over-wet massing” regime in which discrete granule formation could not be obtained. The granules produced in the melt fluidised bed process were subsequently pressed into tablets using an industrial tablet press. The physical properties of the tablets: fracture stress, disintegration time and friability were assessed using industry standards. These analyses indicated that particle size and binder content of the initial granules influenced the mechanical properties of the tablets. It was noted that a decrease in initial granule size resulted in an increase in the fracture stress of the tablets formed.

Investigation of precision grinding process for production of silicon diaphragms

The application of precision grinding for the formation of a silicon diaphragm is investigated. The test structures involved 2-6 mm diam diaphragms with thicknesses in the range of 25-150 //m. When grinding is performed without supporting the diaphragm, bending occurs due to nonuniform removal of the silicon material over the diaphragm region. The magnitude of bending depends on the µNal thickness of the diaphragm. The results demonstrate that the use of a porous silicon support can significantly reduce the amount of bending, by a factor of up to 300 in the case of 50 m thick diaphragms. The use of silicon on insulator (SOI) technology can also suppress or eliminate bending although this may be a less economical process. Stress measurements in the diaphragms were performed using x-ray and Raman spectroscopies. The results show stress of the order of 1 X107-! X108 Pa in unsupported and supported by porous silicon diaphragms while SOI technology provides stress-free diaphragms. Results obtained from finite element method analysis to determine deterioration in the performance of a 6 mm diaphragm due to bending are presented. These results show a 10% reduction in performance for a 75 µm thick diaphragm with bending amplitude of 30 fim, but negligible reduction if the bending is reduced to

Dealing with post-traumatic stress disorder: The psychological sequelae of bloody Sunday and the response of state services

Objective: This article describes the political context of health and social care services in Northern Ireland at a the of intense social conflict. Method: Concepts from post-traumatic stress disorder (PTSD) and other relevant international psychological literature are then used to study the experience of the Bloody Sunday families, victims of a traumatic event that happened in Derry in January 1972. Results: High levels of psychological morbidity within this population are reported, alongside some evidence that families had not received services that may have helped resolve the trauma. Conclusions: The authors noted that new services planned as a result of the current peace process may offer social workers and other professionals new ways to address the unmet needs of people traumatized by the Troubles.

Numerical and Experimental Investigation of Aircraft Panel Deformations During Riveting Process

In collaboration with Airbus-UK, the dimensional growth of aircraft panels while being riveted with stiffeners is investigated. Small panels are used in this investigation. The stiffeners have been fastened to the panels with rivets and it has been observed that during this operation the panels expand in the longitudinal and transverse directions. It has been observed that the growth is variable and the challenge is to control the riveting process to minimize this variability. In this investigation, the assembly of the small panels and longitudinal stiffeners has been simulated using static stress and nonlinear explicit finite element models. The models have been validated against a limited set of experimental measurements; it was found that more accurate predictions of the riveting process are achieved using explicit finite element models. Yet, the static stress finite element model is more time efficient, and more practical to simulate hundreds of rivets and the stochastic nature of the process. Furthermore, through a series of numerical simulations and probabilistic analyses, the manufacturing process control parameters that influence panel growth have been identified. Alternative fastening approaches were examined and it was found that dimensional growth can be controlled by changing the design of the dies used for forming the rivets.

Income, deprivation and economic stress in the enlarged European Union

At risk of poverty indicators based on relative income measures suggest that within the enlarged EU societies located at quite different points on a continuum of affluence have similar levels of poverty. Substantial differences in levels of income between societies do not in themselves invalidate this approach. However, the relative income approach fails to capture the fact that, if countries are grouped in terms of level of GDP, between economic cluster differences in life-style deprivation are sharper at lower income levels. Support for the argument relating to restricted reference groups is found in relation to the contrast between the twelve most affluent EU countries and all others. The limitations of relative income poverty lines have little to do with the process of enlargement as such. Instead the major problem involves the weak association between income and deprivation in the more affluent countries. However, as a consequence of such difficulties, such indicators do not provide entirely meaningful comparisons of levels of disadvantage across economic clusters. The current analysis, rather than supporting the alternative of a focus on absolute income or an EU wide poverty line, suggests that we should take the argument for adopting a multidimensional approach to the measurement of poverty more seriously.